Funding support: The American Migraine Prevalence and Prevention Study is funded through a research grant to the National Headache Foundation from Ortho-McNeil Neurologics, Inc., Titusville, NJ. Additional analyses, writing, and preparation of this manuscript supported by Merck Pharmaceuticals.

Conflicts of Interest: Drs. Bigal, Chen, and Golden are full-time employees of Merck. They hold stocks and stock options of Merck.

Abstract

Background.— Although diagnostic rates for migraine have increased over the past 5 years, the proportion of migraine sufferers using triptans has remained essentially stable.

Objectives.— To assess the rate of onset of new triptan prescriptions among persons with migraine and the predictors of initiating therapy.

Methods.— The American Migraine Prevalence and Prevention Study is a longitudinal study conducted in a representative sample of headache sufferers in the US population. Episodic migraineurs not using triptans in 2005 who continued to have migraine and provided treatment data in 2006 (n = 6865) were included. We assessed predictors of triptan use in univariate and multivariate analyses, including 3 nested models. In Model 1, we adjusted for demographic variables. Model 2 added headache-related disability and cutaneous allodynia. Model 3 added depression and use of preventive headache medications.

Conclusions.— New use of triptans is low in the population. Because adequacy of care was not assessed, future studies should focus on investigating whether this low rate of triptan start is proper or if it reflects an unmet treatment need.